Endoscopic ultrasound staging of rectal cancer: Diagnostic value before and following chemoradiation
Endoscopic ultrasound staging of rectal cancer: Diagnostic value before and following chemoradiation
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DOI：
10.1111/j.1440-1746.2005.03927.x
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发表时间：
2006-02-01
影响因子：
4.1
通讯作者：
Avidan, B
中科院分区：
文献类型：
--
作者：
Maor, Y;Nadler, M;Avidan, B
背景：内镜超声（EUS）已被证明是直肠癌分期的可靠工具。然而，EUS化疗后的准确性仍然不清楚，因此，本文的目的是比较直肠癌EUS分期的准确性之前和之后chemoradiation.Methods：直肠癌患者进行EUS分期分为两组。第一组包括66名患者，他们在EUS分期后接受手术，术前未进行放化疗。第二组包括25名患者，在放化疗后进行EUS评估。结果：I组T分期准确率为86%（57/66），与手术病理分期比较差异有统计学意义（P <0.05）。不准确的分期主要与EUS T2肿瘤的过度分期有关。I组N分期准确率为71%（47/66）。在I组中，EUS对与治疗决策相关的复合T和N分期的准确性为91%。Ⅱ组T分期准确率为72%（18/25），N分期准确率为80%（20/25）。过度分期EUS T3肿瘤占最不准确的分期。EUS分期预测后放化疗T0 N 0阶段正确的cases.Conclusions：直肠癌术前分期EUS是一个有用的方式，在确定术前放化疗的需要。放化疗后的EUS T分期似乎不太准确。完全缓解的检测可能不足以选择患者进行有限的手术干预。(C)2005年Blackwell Publishing Asia Pty Ltd.
Background: Endoscopic ultrasound (EUS) has been shown to be a reliable tool for staging rectal cancer. Nevertheless, the accuracy of EUS after chemoradiation remains unclear; therefore the purpose of the present paper was to compare the accuracy of EUS staging for rectal cancer before and following chemoradiation.Methods: Patients with rectal cancer undergoing EUS staging were stratified into two groups. Group I consisted of 66 patients who underwent surgery following EUS staging without preoperative chemoradiation. Group II consisted of 25 patients who had EUS evaluation following chemoradiation. The EUS staging was compared to surgical/pathological staging.Results: The accuracy of the T staging for group I was 86% (57/66). Inaccurate staging was mainly associated with overstaging EUS T2 tumors. The accuracy of the N staging for group I was 71% (47/66). The accuracy of EUS for a composite T and N staging relevant to treatment decisions in group I was 91%. In group II, the accuracy of T and N staging was 72% (18/25) and 80% (20/25), respectively. Overstaging EUS T3 tumors accounted for most inaccurate staging. The EUS staging predicted post-chemoradiation T0N0 stage correctly in only 50% of cases.Conclusions: Preoperative staging of rectal cancer by EUS is a useful modality in determining the need for preoperative chemoradiation. The EUS T staging following chemoradiation appears to be less accurate. Detection of complete response may be insufficient for selecting patients for limited surgical intervention. (C) 2005 Blackwell Publishing Asia Pty Ltd.